[Chronic desquamative gingivitis. Etiology, clinical and histological features, immunopathological studies, diagnosis...

In this paper the etiology, the clinical and histologic features, the immunopathologic studies, the diagnosis and treatment of chronic desquamative gingivitis are reviewed. Chronic desquamative gingivitis is not a disease sui generis but represents a reaction pattern of the gingivae which conceals other pathological entities. Dermatoses, hormonal disturbances, chronic irritation and idiopathic causes have been incriminated as etiologic factors. Among the dermatoses that manifest as desquamative gingivitis cicatricial pemphigoid, lichen planus, pemphigus vulgaris and bullous pemphigoid are more frequent. Desquamative gingivitis is characterized clinically by a diffuse erythema of the marginal and attached gingivae associated with areas of desquamation and corresponding symptoms. An accurate diagnosis of the underlying disease of chronic desquamative gingivitis can be made on the basis of careful history and clinical observation, light microscopic examination of gingival biopsy specimens, immunopathologic and follow-up findings. The significance of early diagnosis in the therapeutical management of the patients is emphasized. The response to topical corticosteroids as well as systemic corticosteroids and dapsone or sulfapyridine has been gratifying. The identification of the underlying disease in chronic desquamative gingivitis is important and the contribution of the dentist in early diagnosis and prompt therapeutical care is of great value.